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penditure of $13,066,618, whether it includes any hospital attendants or whether it is just the district organization and the suboffices ?
Col. PATTERSON. The sub and district offices; yes, sir.
Col. PATTERSON. Those figures cover a personnel of 4,560, whose annual salaries total $5,912,736.40. I will file a detailed statement for the committee.
The CHAIRMAN. Please give us the next item.
Mr. ROUTSONG. The Sweet bill necessitates the inspection of hospitals and equipment, and it is estimated, as a result of this inspection, that certain changes and improvements will have to be made, which we do not anticipate here. I believe that figure is very low.
The CHAIRMAN. Is that contingent fund to be used without any report to anybody about its expenditure?
Col. PATTERSON. Oh, no. We would have to account for it, of
Mr. ROUTSONG. If we order a change in any Army hospital we have to provide the funds from this appropriation to make that alteration.
The CHAIRMAN. Out of the $250,000?
Mr. ROUTSONG. Out of the medical and hospital service appropriation.
Col. PATTERSON. It can only be used to pay accounts.
Mr. Routsong. There will always be the question of sanitation, the crowding of hospitals, the ventilation, satisfactory hospital equipment, etc., which the inspectors will report upon. We will have to be very careful about making those inspections, because we will have to pay for changes that become necessary as a result of them. We felt that we should make some provision for them.
The CHAIRMAN. How adequate is the present service to meet the needs of those entitled to hospitalization?
Col. FORBES. It is inadequate for certain diseases.
ESTIMATED AMOUNT REQUIRED FOR MEDICAL AND HOSPITAL
The CHAIRMAN. Some time ago you gave us the figures of the number of men in the Army and naval hospitals, the National Soldiers' Home, the Public Health Service, the number of contract hospitals, and gave us an estimate of the rate per day per man. How much will that amount to?
Mr. ROUTSONG. $46,220,571.18.
The CHAIRMAN. Repairs and alterations for army hospitals, $40,000; naval hospitals, $35,000; National Soldiers' Home hospitals, $500,000; Public Health Service hospitals, $2,000,000; dental service, $2,179,614.26; dispensaries, $2,750,000; medical personnel, $900,000; direct disbursements, transportation, $1,500,000; traveling expenses, $500,000; physical examinations, $700,000 medical and surgical (special), $725,000; orthopedic, $120,000; hospitals, contract. $125,000; burial awards, $80,000; dental service,
fees, $5,000,000, and district organizations, $13,066,618, and contingent fund to district organization, $250,000. How much does that figure up?
Mr. ROUTSONG. Did you include the contract patients ?
The CHAIRMAN. Nine thousand one hundred and sixty-two patients at $3.68.
Mr. ROUTSONG. Yes, sir.
The CHAIRMAN. The grand total of the two items makes $76,691,803.44.
Mr. Routsong. Yes, sir.
TOTAL NUMBER OF BEDS OCCUPIED.
The CHAIRMAN. How many beds are occupied in the hospitals and how much space is not occupied, if you know?
Col. PATTERSON. How many beds are occupied at the present time? The CHAIRMAN. Yes, sir.
Col. PATTERSON. There were 29,052 patients in the hospitals as of October 27, 1921.
The CHAIRMAN. Does that cover all the space you have available ? Col. PATTERSON. No, sir.
NUMBER OF BEDS AVAILABLE.
The CHAIRMAN. How much available space have you?
Col. PATTERSON. Seven thousand eight hundred and fifteen beds available. They are not in the places that we need them in many instances, but they are available.
The CHAIRMAN. What do you mean by they are available but not in the proper place?
Col. PATTERSON. We might need 200 beds in New England and they would be in the South somewhere; not where we want them.
The CHAIRMAN. Is there a shortage of hospital space for those who have to be treated ?
Col. PATTERSON. Yes, sir; in several sections.
The CHAIRMAN. Where does that shortage exist, if you can give us the location ?
Col. PATTERSON. I should like to preface that by saying that the desire is to get out of the contract hospitals as soon as possible and to but all beneficiaries in Government-controlled institutions.
Mr. KELLEY. The contract hospital is much the cheapest ?
Col. PATTERSON. You do not get the service. Some of them are splendid institutions. A metropolitan hospital with which we have a contract is a splendid institution, but in many instances the contract hospitals are little better than boarding houses, and an unfit place for the adequate care of our beneficiaries.
Mr. Sisson. Those are the institutions in which the citizens must go to be treated ?
Col. PATTERSON. Not altogether. You will find that a great many mushroom institutions have grown up to care for the beneficiaries of the Veteran's Bureau.
Mr. GALLIVAN. All of these contract institutions are of the kind you describe?
Col. PATTERSON. No. I have just stated that there are many excellent ones, but the majority are not places for our people.
The CHAIRMAN. I think it would be beneficial to an intelligent understanding of this hearing, instead of going on along sidelines, if you would just give us a very simple statement of the hospital facilities which we have, the number of patients we have, the locations throughout the country, where the shortage of space exists, what will have to be done to supply the space, whether anything is being done in the matter of building new hospitals and what progress has been made?
Col. PATTERSON. I might say that there has recently been appointed a Federal Board on Hospitalization, which is sitting every morning in the city here.
The CHAIRMAN. We do not care about that; all we want to know are the facts.
Col. PATTERSON. This was preliminary to what you want to know, sir. It will probably make some more accurate recommendations than we are going to cover,
The CHAIRMAN. Please just give us the facts.
Col. PATTERSON. We need a 500-bed hospital in California for tuberculosis.
SHORTAGE OF BEDS POR CARE OF TUBERCULAR AND INSANE PATIENTS.
The CHAIRMAN. That is not what we want to know. We want to know what hospital facilities you have, whether we have enough to meet the present needs, and if we have not, where the shortage is, and then, after you get through, tell us what you are doing to supply the shortage.
Col. PATTERSON. We had on October 27, 1921, 29,052 patients in hospitals. Of that number 19,584 were in Government institutions, the remainder being in contract hospitals, which, as I have already said, we desire to get out of for very good reasons. We are short of beds for the treatment of tuberculosis in two general localities.
The CHAIRMAN. Please give us the localities.
Col. PATTERSOx. California is one and the other is the metropolitan area of New York. When the hospitals now being constructed for the bureau for the treatment of tuberculosis patients or in contemplation are completed we will have enough to meet all needs.
The CHAIRMAN. What progress is being made toward their completion
Col. PATTERSOX. A number will be completed between now and next lugust, some of them in February, some in April, May, and June, and as late as August.
BILL FOR CONSTRUCTION OF HOSPITALS.
The CHAIRMAN. There has been suggested the introduction of y bill through some Member of either the House or Senate for the expenditure of $16,000,000 more for new hospitals. Is there any necessity for that!
Col. PATTERSON. Some of that money will be needed.
Col. PATTERSON. No, sir; but on the other ones which we will need.
The CHAIRMAN. I thought you had enough now?
Col. PATTERSON. I said we will have enough when these now being constructed are built, plus the hospitals for the tuberculosis patients in California and in the metropolitan area.
The CHAIRMAN. If that is the case what necessity would there be for starting the construction of new hospitals, except those two?
Col. PATTERSON. There are some other classes of cases, the neuro, psychiatric cases, men with mental disturbances. We will need 1,000 beds for the insane in the State of California.
The CHAIRMAN. Have you no facilities there now? Col. PATTERSON. No, sir. We are using the contract hospital. They want us to get out of them. In addition to that, in order to utilize the Speedway Hospital for neuropsychiatric cases, there will have to be built a small addition to a Public Health hospital now in Chicago about 200 beds in order to provide for general cases which must be moved from that hospital.
The CHAIRMAN. The Public Health Service hospital on the lake shore !
Col. PATTERSON. There are two of them in Chicago. By enlarging one of them by 200 beds, with the other hospital they have there, they can take care of general cases and take them out of the Speedway Hospital so we can maintain that hospital for neuropsychiatric cases. We need certain general hospitals. We need one with about 500 beds in the general neighborhood of St. Louis.
Mr. Wood. Is there not a hospital out there, the Morris Hospital?
Col. PATTERSON. There is a hospital at Excelsior Springs that is being constructed.
Mr. Wood. I have heard some talk about a hospital being built by a man under contract at his home.
Col. FORBES. That is the Morse Hospital at Excelsior Springs, out in Kansas City. That is a small institution.
Col. PATTERSON. There is need again for some beds in the metropolitan area of New York. We are providing for the nervous cases there. You probably remember that one-fifth of all the men who served in the war came from New York. We are looking for another hospital for tuberculosis patients in that area, and when we have that we will still have to provide for general beds in New York City. In order to do that we have to find 600 beds. The committee that I mentioned is looking into a hospital in Brooklyn and the enlargement of the marine hospital on Staten Island at Stapleton to provide the 600 beds. That will enable us to get out of the Polyclinic Hospital, which we should hold no longer, and the Fox Hills Hospital, the lease on which expires next June; we have to get out. Those are two of the needs at the present time, subject to revision, as the result of further study by the Federal Board on Hospitalization.
The CHAIRMAN. Generally speaking, you are able to care now for all those who need hospitalization!
Col. PATTERSON. We are doing it, but by using the contract hospitals.
Mr. BYRNS. Under this appropriation of $18,600,000 for hospitals, are you going to take care of the new hospitals that you referred to out of this appropriation ?
Col. PATTERSON. That appropriation has practically all been allocated, and in addition to that money must be made available for these other places which I have just mentioned-two tuberculosis hospitals, one large insane hospital, and an addition to another hospital in Chicago to make room there for general cases, so that we can use the Speedway.
The CHAIRMAN. You have mentioned making use of the bill introduced for $16,000,000 ?
Col. PATTERSON. Yes, sir.
Col. PATTERSON. No; it will probably take 11 or 12 million dollars for hospitals, the balance for dispensaries.
The CHAIRMAN. In addition to the $18,000,000 appropriation ? Col. PATTERSON. Yes, sir.
The CHAIRMAN. If that should become a law, how long would it be before those buildings could be put into service?
Col. PATTERSON. From 10 months to a year and a half at the longest. Eighteen months would see them all running.
The CHAIRMAN. As I recall the early part of the hearings it was suggested that you had 30,000 in hospitals, and that the number expected at the peak would be 35,000. Does the necessity for these new facilities seem to be warranted by the increased number of 35,000?
Col. PATTERSON. Yes, sir; we think so. We think we will have to have this, and it will be rather bad not to be able to take care of them. As you know, our hospital requirements are going up instead of down, and we expect them to continue to do so until about the 1st of March Then we-expect the cases will begin to go down.
Mr. Byrns. Is there any reason why these additional hospitals should not be constructed at the soldiers' homes or at other points where, as the years go by and you no longer have a need for the hospitals for these present purposes, they can be turned into barracks or something of that sort ?
Col. PATTERSON. In almost every case they are trying to locate those hospitals where, if they should not be needed after a few years, they would still be an asset to the Government in some form or other, either for the Public Health Service in taking care of its beneficiaries, or, perhaps, for Army or Navy uses. In other cases, it is thought that some States would take them over. They are all being located with that end in view.
ALLOCATION OF FUNDS FOR CONSTRUCTION OF HOSPITALS.
The CHAIRMAN. The funds for the hospitals that were presumed to be constructed out of the appropriation of $18,600,000 have been allocated.
Col. PATTERSON. All but about $1,300,000.
Col. FORBES. I can give that. There are $850,000 for Fort Bayard, $600,000 for Prescott, Ariz.; $2,750,000 for the Catholic Orphanage in New York; $495,000 for Fort Walla Walla, Washington
The CHAIRMAN (interposing). That is at an abandoned military